Provider Demographics
NPI:1558612671
Name:PENNINGTON, LEONA ELIZABETH (PNP)
Entity Type:Individual
Prefix:MS
First Name:LEONA
Middle Name:ELIZABETH
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:LEONA
Other - Middle Name:ELIZABETH
Other - Last Name:PENNINGTON-COTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 GREEN ST E
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4105
Mailing Address - Country:US
Mailing Address - Phone:252-243-9800
Mailing Address - Fax:252-243-9888
Practice Address - Street 1:4355 HICKORY BLVD STE 2
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-2014
Practice Address - Country:US
Practice Address - Phone:828-757-5050
Practice Address - Fax:828-757-5051
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC154108363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics